Medication non-adherence in inflammatory bowel diseases is associated with disability
Intestinal Research
;
: 571-578, 2018.
Article
in English
| WPRIM
| ID: wpr-717947
ABSTRACT
BACKGROUND/AIMS:
Medication non-adherence is common in inflammatory bowel diseases (IBD). The short-term consequences of non-adherence include increased disease relapse but the long-term impact upon patients in terms of daily functional impairment are less well characterized. Identifying negative outcomes, such as disability, may encourage adherence.METHODS:
Consecutive ambulatory IBD subjects completed the Medication Adherence Rating Scale (MARS; non-adherence defined as ≤16), Inflammatory Bowel Diseases Disability Index (IBD-DI; disability < 3.5) and Beliefs about Medicines Questionnaire (high necessity/concerns ≥16). The primary outcome was the association between medication non-adherence and disability. Secondary outcomes were the predictors of these outcomes.RESULTS:
A total of 173 subjects on IBD maintenance medications were recruited (98 Crohn’s disease, 75 ulcerative colitis median IBD-DI, –5.0; interquartile range [IQR], –14.0 to 4.0 and median MARS, 19.0; IQR, 18 to 20) of whom 24% were non-adherent. Disability correlated significantly with medication non-adherence (r=0.38, P < 0.0001). Median IBD-DI for non-adherers was significantly lower than adherers (–16.0 vs. –2.0, P < 0.0001). Predictors of disability included female sex (P=0.002), previous hospitalization (P=0.023), management in a referral hospital clinic (P=0.008) and medication concerns (P < 0.0001). Non-adherence was independently associated with difficulty managing bowel movements (odds ratio [OR], 3.71; 95% confidence interval [CI], 1.50–9.16, P=0.005), rectal bleeding (OR, 2.69; 95% CI, 1.14–6.36; P=0.024) and arthralgia/arthritis (OR, 2.56; 95% CI, 1.11–5.92; P=0.028).CONCLUSIONS:
Medication non-adherence was associated with significantly increased disability in IBD. Female gender, higher disease severity and medication concerns were additional predictors of disability.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Recurrence
/
Referral and Consultation
/
Inflammatory Bowel Diseases
/
Colitis, Ulcerative
/
Crohn Disease
/
Mars
/
Compliance
/
Medication Adherence
/
Hemorrhage
/
Hospitalization
Type of study:
Prognostic study
Limits:
Female
/
Humans
Language:
English
Journal:
Intestinal Research
Year:
2018
Type:
Article
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